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Some women develop diabetes for the first time while they are pregnant — a condition known as gestational diabetes. But if you already have diabetes, keeping your blood sugar within the target range before and during pregnancy is the most important thing that you can do for yourself and your child. If you are able to maintain good blood glucose levels, your chances of having a healthy baby are just about as good as they are for women who don’t have diabetes.

It's important to get your glucose levels under control well before you even try to get pregnant, because most women don't know they are carrying a child for several weeks following conception. If your blood sugar levels are off during the first six weeks of a pregnancy, when an infant's organs are forming, it can cause your baby to develop birth defects. High blood sugar levels and ketones (a potentially toxic byproduct of having diabetes) will be passed on to your baby.

Because these first few weeks are so critical, women who have diabetes should plan their pregnancies. The American Diabetes Association recommends that women with diabetes have their blood glucose under control for three to six months prior to getting pregnant.

Good Prenatal Care for Women With Diabetes

To get the best care for you and your baby, choose a primary care physician who is specifically trained in caring for pregnant women with diabetes, and an obstetrician experienced in treating pregnant women with diabetes and other high-risk pregnancies. You might also want to see a registered dietitian to help you eat a healthier diet during pregnancy. Select a pediatrician or neonatologist who has specialized experience in treating babies of mothers with diabetes.

You should know that during pregnancy, your diabetes may be harder to manage. If you have type 1 diabetes, your insulin regimen may change. Your body will need more insulin, especially during the last trimester. This is because the placenta makes hormones to help the baby develop. Those hormones interfere with the action of your insulin. If you have type 2 diabetes and take pills to control your blood sugar, you may have to stop while pregnant and switch to insulin.

Exercise and a good diet are crucial to a healthy pregnancy, so speak to your health care providers for advice on whether to make changes to what you eat and how you exercise.

If your blood glucose is out of control during pregnancy, your baby is apt to be large because the infant's blood glucose is also too high. A large baby can suffer nerve damage while squeezing through the birth canal during delivery and is more likely to become obese as a child and develop type 2 diabetes when older. These are just a few of the reasons why tight glucose control is a priority.

Delivery Time!

Regardless of how you deliver your baby, vaginally or via cesarean section, your physician will need to keep your blood glucose in your targeted range during delivery. When labor starts, insulin levels need to drop. It's doubtful that you'll need any insulin during labor or for one to three days following delivery. Because of your special needs related to diabetes, home births are not recommended.

You might notice that for several weeks after delivery, you have better blood glucose control. On the other hand, you could experience some swings due to stress, a lack of sleep, or an inconsistent diet. You'll need to pay close attention to your diet to avoid dropping into a low blood glucose level; plan ahead for healthy meals and snacks, and drink plenty of fluids. Monitor blood glucose often during these first weeks. Low glucose levels can occur while nursing, so be sure to have a healthy snack before nursing, and keep some food close by while nursing in case you feel symptoms of low blood sugar.

Take these steps before, during, and after pregnancy to ensure your own good health and that of your new baby.